Pain Management After Pediatric Hematopoietic Cell Transplantation: A Narrative Review of Pain Phenotypes, Assessment, and Multimodal Care

Vollständiger Abstract

Worum geht es in dieser Arbeit?

ABSTRACT Pain is a common and clinically significant complication of pediatric hematopoietic cell transplantation (HCT). It evolves across conditioning, engraftment, early recovery, and survivorship, and may result from mucosal injury, procedures, graft‐versus‐host disease (GVHD), infection, medication toxicity, immobility, and long‐term complications. Pediatric HCT‐specific guidance remains limited, so practice is often extrapolated from broader pediatric oncology, adult HCT, and supportive/palliative care literature. This narrative review summarizes major pain phenotypes after pediatric HCT and emphasizes developmentally appropriate, repeated assessment; phenotype‐based pharmacologic management; and multimodal care integrating opioids, adjuvant analgesics, nonpharmacologic strategies, rehabilitation, child life, psychology, pharmacy, and palliative care. Evidence remains fragmented. Future work should prioritize standardized pain phenotyping, patient‐ and proxy‐reported outcomes, longitudinal assessment of pain and function, and multicenter supportive‐care pathways extending beyond acute transplant.